The importance of geriatric dentistry in the context of ... · Alexandre Franco Miranda, Catholic...

Alexandre Franco Miranda

The importance of geriatric dentistry in the context

of gerontology: home care and hospital services -

the reality of a service in Brazil

Brazil

Theme:

Improving Health and Health Care Services for the Elderly

- Oral health in patients with Alzheimer‘s

- Advanced stages of Alzheimer´s

- Home care and Hospital services

- Gerontology and Dentistry

Alexandre Franco Miranda, Catholic University of Brasilia, Brazil

The importance of geriatric dentistry in the context of gerontology: home care and hospital services - the reality of a service in Brazil

- No conflicts of interest;

- All images have been authorized by signing an informed consent ;

- All images used have the technical and scientific purpose;

- Experience of more than 10 years dedicated to home and hospital dental

care (ICU and surgical center) in patients with Alzheimer's disease for health

and quality of life – GERONTOLOGY;



The present study, EXPERIENCE REPORT, aims to address the

behaviors, clinical techniques, management, adaptation and evaluation of

the knowledge of health professionals about the appropriateness of the oral

environment conducted in patients suffering from neurodegenerative

diseases (Alzheimer's) in Brasilia, Brazil.



* Health promotion

* Quality of life

* Biopsychosocial interference

* Family participation

* Interdisciplinary planning

Oral health Dentist

Gerontology context

Alzheimer´s

disease



Brazil

Age pyramidal

Data: Brazilian Institute of Geography and Statistics

www.ibge.gov.br

LAST DEMOGRAPHYC SENSE, 2010



Brazil

Epidemiology

Increased life expectancy (average): 73 years

Men - 69 years

Women - 77 years

2025: 2 children / 6 old people

2050: 1 child / 5 old people

Data: Brazilian Institute of Geography and Statistics

www.ibge.gov.br

LAST DEMOGRAPHYC SENSE, 2010



Aging in Brazil

* Increased number of specific diseases;

* Need for multidisciplinary action (health professionals and FAMILY);

* Increase in public financial support (social programs, health, ...);

* Training, professional skills and differentiation (Geriatric dentistry) - NEED OF BRAZIL

Especially home and hospital fragile elderly

ALZHEIMER´S DISEASE



Geriatrics and Gerontology Interactions

- Vascular (brain) diseases

- Heart Diseases

- Pulmonary Diseases

- Diabetes

- Cancer

- Osteoporosis

-Alzheimer's

- Vascular Dementia

- Parkinson

- Rheumatoid Arthritis

- Orofacial Pain



Geriatrics and Gerontology Interactions


2009

2004

2014



Home dentistry

“Adaptation of the dentist to the context and reality of the frail elderly patient”



Home dentistry

The proper treatment planning is of great importance because only the

essential procedures should be performed at the individual residence -

elimination of inflammatory processes, infections and pain.

THE GERONTOLOGY PLANNING WITH OTHER HEALTH PROFESSIONALS AND FAMILY PATIENT IS VERY IMPORTANT



Home dentistry

Restoration – Adequacy of the

oral cavity

Training of family members and

caregivers to promote oral health;

Adaptation



“The importance of elderly oral health in hospital”

Hospital dentistry



Hospital dentistry

"... elderly patients have a higher prevalence of hospital admissions due to

pulmonary problems (PNEUMONIA) and require specific care ...." Terpenning et al.,2001; Benatti & Montenegro, 2010

"... severe patients, intubated and mechanically ventilated at higher risk of

lung infection..." Mojon, 2002; Oliveira et al., 2007



Home and Hospital dentistry ALZHEIMER´S DISEASE

The difficulty for the promotion of oral health

Patients in advanced stages of Alzheimer's disease are not employees and depends

on other professionals to promote oral health - there is a lack of professional training to

assist these patients. Friedlander, 2006; Miranda et,al, 2010





Intensive Care Unit





“Auxiliary means” “Facilitators” to access the oral cavity

Professional ability

Correct use





“Auxiliary means” “Facilitators” to access to the oral cavity

Intensive Care Unit Home care





CASE 1









CASE 2








The importance of geriatric dentistry in the context of gerontology:

home care and hospital services – QUALITY OF LIFE



Conclusions

* Need for a higher number of trained dentists for

these types of calls with an interdisciplinary

planning;

* Need for greater integration of oral health into

the context of geriatrics and gerontology;

* Need for more scientific articles on this topic;

* Greater disclosure of such health assistance to

frail elderly with Alzheimer's;

* Geriatric dentistry is important to the elderly

patients health and quality of life with essential

services that exist in all the world.


Thank you so much!



Alexandre Franco Miranda

Coordinator and Professor of Geriatric Dentistry, Special Patients

(Special Groups) and Clinical Dentistry for Special Patients

Catholic University of Brasilia (UCB), Brazil

Home and Hospital services in Dentistry

(Surgical center / Intensive Care Unit)

Specialist in Gerontology

Brazilian Society of Geriatrics and Gerontology

+ 55 61 81369896

+ 55 61 33569612

+ 55 61 30376530

[email protected]

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